“……In response to the emerging challenge of the obesity epidemic, the WHO Regional Office for Europe organized the WHO European Ministerial Conference on Counteracting Obesity, which took place in Istanbul, Turkey on 15–17 November 2006.

This book collects the papers that were written by a large group of experts in public health, nutrition and medicine to provide background for the Conference; a smaller book already published by the Regional Office summarizes many of their conclusions.1 Both this book and the summary illustrate the dynamics of the epidemic and its impact on public health throughout the European Region. In particular, the obesity epidemic’s rapid expansion to the countries in the eastern half of the Region causes great concern, as they now suffer from a double burden of disease linked to both under- and overnutrition….”

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings and interpretations included in the Materials are those of the authors and not necessarily of The Pan American Health Organization PAHO/WHO or its country members”.---------------------------------------------------------------------------------------------------

IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.

"..... Cuba's economic crisis of 19892000 resulted in reducedenergy intake, increased physical activity, and sustained population-wideweight loss. The authors evaluated the possible associationof these factors with mortality trends. Data on per capita dailyenergy intake, physical activity, weight loss, and smoking weresystematically retrieved from national and local surveys. Nationalvital statistics from 19802005 were used to assess trendsin mortality from diabetes, coronary heart disease, stroke,cancer, and all causes.

The crisis reduced per capita dailyenergy intake from 2,899 calories to 1,863 calories. Duringthe crisis period, the proportion of physically active adultsincreased from 30% to 67%, and a 1.5-unit shift in the bodymass index distribution was observed, along with a change inthe distribution of body mass index categories.

The prevalenceof obesity declined from 14% to 7%, the prevalence of overweightincreased 1%, and the prevalence of normal weight increased4%. During 19972002, there were declines in deaths attributedto diabetes (51%), coronary heart disease (35%), stroke (20%),and all causes (18%). An outbreak of neuropathy and a modestincrease in the all-cause death rate among the elderly werealso observed. These results suggest that population-wide measuresdesigned to reduce energy stores, without affecting nutritionalsufficiency, may lead to declines in diabetes and cardiovasculardisease prevalence and mortality. ..."

"Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings and interpretations included in the Materials are those of the authors and not necessarily of The Pan American Health Organization PAHO/WHO or its country members".---------------------------------------------------------------------------------------------------PAHO/WHO Website: http://www.paho.org/EQUITY List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html

IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.

"....In 1662 John Graunt, a London haberdasher, published his magnumopus, Natural and Political Observations ...Made upon the Billsof Mortality, and thereby established the field of epidemiology.1Graunt brought to light a diversity of facts about human lifeand disease that had not previously been appreciated. He wasthe first to noticethat the number of births and deaths ofmales exceeded those of females (by the ratio of 14 to 13);he noticed, too, that despite their greater mortality, men hadless morbidity than women. Graunt quantified for the first timethe high mortality in children, noting that one-third died bythe age of five. He documented that plague actually claimedmany more deaths than had been ascribed to it, and he demonstratedthat the frequency of rickets increased over the span of a fewyears from zero fatal cases to a level that indicated a seriousepidemic...."

".....Though published in 1981, the footnote on the first page of‘The Rise and Fall of Epidemiology’1 indicates thatit was a preprint of a talk ‘to be presented December10, 2004, at the annual meeting of the John Graunt LiterarySociety, Harvard School of Public Health, Boston.’ Backin the 1970s, the facetiously named John Graunt Literary Society,or JGLS, met each Friday in the late afternoon at the Harvardepidemiology department to celebrate Graunt's legacy with brewedbeverages. Although the December date 23 years in the futureat the time of publication was in fact a Friday, the ‘preprint’implied that the JGLS was destined to evolve from a weekly beerfestinto a yearly gathering of sober, serious speeches. In an essaythat many readers took to be a cynical rant laden with gloomypredictions, this forecast for the JGLS was the gloomiest ofall.

In fact the essay was not intended to predict the future ofepidemiology, which I have always held to be bright.It wasmeant to be a warning about the growth of research bureaucracyand its effect on epidemiologic research...."

Commentary: Epidemiology and futurology—why did Rothman get it wrong?Cesar G Victora - Universidade Federal de Pelotas, CP 464-96001-970 Pelotas, RS, Brazil. Int. J. Epidemiol. 2007 36: 712-713; doi:10.1093/ije/dym153 [Extract][Full Text][PDF]".....Ken Rothman is a household name for epidemiologists all overthe world. The appearance of his book ‘Modern Epidemiology’1in the mid-1980s consolidated his reputation as a major thinkerin our discipline. I remember finding his book truly inspirationalwhen I first read it as a junior epidemiologist.

Rothman's commentary on ‘The rise and fall of Epidemiology,1950–2000 A.D.’,2 however, made manyepidemiologistsworry. This paper, published in 1981, reads as if it had beenwritten in the beginning of the 21st century, for presentationat the ‘John Graunt Literary Society’ at Harvardin 2004, pretending to look back at the downfall of our discipline ..."

"......with regards to the corporate influences on epidemiology,there is no simple solution. However, for the last two decadesthere has been substantial discussion on ethics in epidemiology,49–52partly in response to the unethical conduct of many industry-fundedconsultants. A number of websites (e.g. http://www.ucsusa.org/scientific_integrity/and http://www.cspinet.org/integrity/) are now devoted to fosteringintegrity in science. Recently there have been renewed callsfor scientists to‘engage in processes to assert positiveprinciples of ... how science should work, and how it shouldbeapplied to public policy decisions’ rather than simplyhaving a list of what not to do.30 This will require‘strongpressure from within the scientific community for codes of ethicsconduct and financial conflict of interest’30 with thegoal, not of restricting what people can do, but to ensure completetransparency ‘through full declaration of potential sourcesof conflicts of interest’.14 Ultimately, perhaps whatis needed is to create some sort of licensure in which epidemiologistswould ‘sign up’ to not take funding from any vestedinterests (corporate or otherwise)..."

".....According to Pubmed, the pessimistic and rather emotional paperof Ken Rothman on the presumed rise and fall of epidemiologyin 19801 was his 59th after being in the ‘business’for almost 10 years. He was undoubtedly speaking on behalf ofmany of his colleagues at the time in expressing the threateneddemise of his profession. By 2007, having become an influentialteacher, he has been involved in 209 articles on a wide rangeof subjects, often in the domain of congenital defects, earlylife exposures, pharmaco-epidemiology and disease aetiology.In 1981, he was still optimistic enough to found the New EnglandEpidemiology Institute which was to successfully train a largenumber of post-graduate students in the subsequent 20 years,and he became the first editor of Epidemiology in 1990. Today,he is still actively teaching and advising all over the worldand co-authoring articles. So, if he did not live up to hisown prediction or sought to refute it, were his alarming earlywarnings appropriate?..."

".....Epidemiologists are in increasing demand to provide answersto new problems of health and the causes of disease,of diseaseprevention and of health care, and to refine the methods usedto monitor or predict trends in disease control. The publichealth applications of epidemiology continue to expand, frommalaria control in Malawi to the eradication of onchocerciasisin sub-Saharan Africa; from reducing the toll of road trafficaccidents to designing cancer control programmes; from healthservices research to defusing the obesity timebomb; and fromracial or socio-economic inequalities in the outcome of healthcare to projections of the tobacco-related disease epidemicin China.

Rothman's terrible gloom in 1981 overlooked the inherent strengthof epidemiology. It is a science that tells us what we wantto know about the human condition and, often, how it might beimproved, in a way which no other science can offer.It is thescience that underpins public health.

Less than 10 years ago, tongue firmly in cheek, Rothman co-wrote:‘Should the mission of epidemiology include the eradicationof poverty?’42 Mission impossible, even for a sciencethat can contribute hugely, but Rothman the epidemiologist seemsto have recovered his panache.

A science lives by the strength of its precepts, the intellectualvigour of those who practise it and the benefits it brings tomankind. By those standards, epidemiology is still very muchalive, and looking good....."

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings and interpretations included in the Materials are those of the authors and not necessarily of The Pan American Health Organization PAHO/WHO or its country members”.---------------------------------------------------------------------------------------------------PAHO/WHO Website: http://www.paho.org/EQUITY List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html

IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.